Is Silicone Safe to Be Injected in the Nasal Fold?

Doctor Answers 7

I do not inject silicone into the nasolabial folds

February 27th, 2010

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I have performed more than 1,000 microdroplet silicone injection procedures during the last 8 years with Silikon-1000. This medical grade silicone oil is FDA approved for intraocular injection and thus its use for any other purpose is considered off-label. I use Silikon-1000 in a microdroplet injection technique to rebuild the volume of the face in HIV patients who have lost facial fat due to their disease and treatment.

Even in these patients, however, I will not use silicone in the nasolabial folds for the following reason: silicone is a stimulatory filler. When we use it in a microdroplet technique it is not so much the volume of the silicone that creates the building of the face, but a combination of the silicone droplets and the collagen that is created by the cells called fibroblasts in response to the silicone.

The nasolabial folds are an area of the face that is in perpetual movement, with eating, smiling, kissing, etc. As it takes time (1-2 months) for the collagen to be created and surround the injected silicone droplets, it is very possible that in many cases the silicone droplets will be pressed into the lateral edge of the nasolabial fold. As a result, one can then get a permanent volume elevation where it wasn't intended. It is much preferable to use a temporary but relatively long lasting filler for this area, such as the Restylane, Juvederm or Radiesse.

It depends on the physician, and the product.

June 12th, 2009

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Dear Ely,

I read the responses of the other physicians, and I respectfully disagree with most of them.

I have been personally using Silikon-1000 for cosmetic facial enhancement since my Fellowship in Advanced Facial Plastic and Reconstructive Surgery without significant incident. The vast majority of my patients are thrilled with their results, and complications are few. My mentor who trained me to perform the micro-droplet injection technique has a 45 year favorable experience with liquid silicone injections.

I counsel my patients that several treatments are typically necessary to achieve a desired result, and that he most common problem is overcorrection and the development of nodules or bumps at the sights of injection. In my hands this occurs in 3% of patients, and these are usually small and easily treated with dilute triamcinolone (steroid) injections or light electrosurgery.

I have not seen migration, pain, or recurrent inflammation in any of my patients.

Silikon-1000 is a permanent filler, so your results, good or bad, are permanent. You should find a board-certified dermatologist or facial plastic surgeon experienced with the micro-droplet technique. You should also see many before and after photos demonstrating beautiful results before you pick your doctor.

Silicone is Safe and Ideal for Filling Nasolabial Folds

January 24th, 2010

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I have been using liquid injectable silicone (Silikon-1000 and Adato-Sil 5000) “off-label” as a filler for several years, and my mentor and father, has been using it for over 40 years. I have read the answers from other physicians and disagree with many things said.

I believe liquid injectable silicone to be safe and incredibly effective when used appropriately, and great for natural-looking results. We use it for acne scarring, aging grooves and wrinkles on the face which include the nasolabial folds (grooves from the nose corner to the mouth corner), hollows and grooves around the eyes, fine lines on the neck, hollows in the temple area, facial lipoatrophy, and for aging grooves on the hands.

Silicone is precise and permanent. There is no need to harvest tissue from another site on your body or to test for a possible allergy. Silicone can be used alone or in conjunction with other facial rejuvenation procedures such as Botox, laser skin resurfacing, chemical peels or facial surgery, helping to create a rejuvenated, natural-looking, smooth appearance.

There is minimal discomfort with liquid injectable silicone treatments when performed with a topical anesthetic. The number of treatments required will depend on the depth and nature of the depressions being treated and the severity of those areas. While most patients do not receive their complete level of improvement during their first visit, they do notice an immediate change just after the first treatment and are thrilled. Treatments are usually done at monthly intervals and are spread over several months. Typically, you will notice more improvement with each treatment. As you approach your desired result, treatments can be spaced at longer intervals of time between treatments. Our patients love it!

While it has not happened to me, a small "bump" or nodule can occur at the sites of injection. It is my opinion and my mentor’s opinion that these bumps or nodules are a result of either placing too much product in one treatment or injection, or by injecting the silicone too close to the surface of the skin. These are easily treated with intralesional steroid (Kenalog) injections, electrosurgery or oral antibiotics.

Silicone is an ideal filler when used correctly by physicians who have taken the time to learn how to properly use it and who respect it. We also spend a good amount of time educating our patients on silicone and on what the treatments involve, which is essential.

Silicone injections can be disastrous

February 9th, 2009

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Silicone is theoretically inert. In other words, the body is not supposed to react to the polydimethylsiloxane. However, we have since found that in countless cases, the silicone can induce a very unique and virulent inflammatory response that can literally deform the soft tissue. This is seen typically in the face, but is not uncommon in the breast, buttocks, and trunk.

Polydimethylsiloxane has a very unpredictable safety profile and should not be used as a facial filler. In many cases, it works fine, but in others, the results are debilitating and disastrous.

Correcting silicone injections is difficult and time consuming. I have focused a great deal of attention on correcting silicone deformities of the face and body. These deformities are typically iatrogenic and can invariably deform the body and lead to serious health problems.

I would not recommend silicone on nasolabial folds

February 9th, 2009

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Pure silicone in droplet form can shift and cause granulomatous reactions. I have seen cases where it has literally caused abcesses and eaten through the skin. It is not approved by the FDA and I would definitely not recommend it. There are other safe fillers that can be injected and even one permanent one if the patient desires. In short, stay away from direct silicone injections.

Silicone is unsafe if not encased

February 9th, 2009

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There is no silicone approved by the FDA for this use. Silicone is sometimes used off-label to fill the eyeball, and after surgery it is used by some to be injected under the skin. Long terms effects of this are unknown.

Silicone is known to migrate if not encased. That is why breast implants were developed over silicone injections into the breast. There are many good alternatives to silicone injections, such as Juvederm, Restylane, or Radiesse.

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